Advocating for cytomegalovirus maternal serologic screening in the first trimester of pregnancy: if you do not know where you are going, you will wind up somewhere else

Ville, Y.

doi:10.1016/j.ajogmf.2021.100356

Cited by 17 publications

(26 citation statements)

References 43 publications

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“…In the present study, viral load in the amniotic fluid was independently associated with associated anomalies at fetal MRI. Furthermore, 60% of the associated anomalies detected by MRI were more common when the amniotic fluid viral load was higher than 10 6 . In this scenario, future studies should be directed at elucidating the optimal cut‐off of CMV load in the amniotic fluid able to predict an adverse outcome, especially in fetuses not presenting anomalies on ultrasound and MRI.…”

Section: Discussionmentioning

confidence: 99%

“…CMV infection is the most common congenital infection and has been described as an ‘unmet public health issue’, owing to the high burden of short‐ and long‐term sequelae, mostly affecting the CNS and neurodevelopmental outcomes 6 . Accurate prenatal prediction of the postnatal prognosis of fetuses with CMV infection is still challenging, and parental counseling is often based on the results of observational studies that date back many years and do not adequately take into account the role of prenatal imaging in predicting perinatal and neurodevelopmental outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Considering the significant clinical relevance of congenital CMV infection and that it is commonly associated with no or non-specific symptoms, many researchers advocate universal maternal serologic screening for CMV in pregnancy, while others defer the antenatal diagnosis to suspected findings at ultrasound 6 .…”

Section: Introductionmentioning

confidence: 99%

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Role of fetal magnetic resonance imaging in fetuses with congenital cytomegalovirus infection: multicenter study

D’Antonio

Mascio

Rizzo

et al. 2023

Ultrasound in Obstet & Gyne

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What are the novel findings of this work? Fetal magnetic resonance imaging (MRI) can detect additional brain anomalies in about 10% of fetuses with congenital cytomegalovirus (CMV) infection and normal neurosonography. CMV viral load was the only independent predictor of fetal anomalies on MRI later in gestation, thus confirming its prognostic value, mostly when associated with antenatal imaging. What are the clinical implications of this work?The findings of this study support the value of detailed imaging follow-up throughout the remainder of the pregnancy after the diagnosis of fetal CMV infection and the use of fetal MRI even in cases of negative neurosonography to better predict the postnatal prognosis of infected newborns.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Role of fetal magnetic resonance imaging in fetuses with congenital cytomegalovirus infection: multicenter study

D’Antonio

Mascio

Rizzo

et al. 2023

Ultrasound in Obstet & Gyne

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show abstract

“…In fact, the 11–14 week’ consultation has become an unmissable one worldwide, and it would represent the most practical compromise if only one sample can be taken. Moreover, valaciclovir, that can be safely used in the early fetal period, decreases vertical transmission by 70% and should be implemented as soon as possible after maternal infection ( 44 ). Based on long-term experience, we have reasons to believe that maternal screening provides superior and beneficial results in both the short and long terms ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

Association Between First-Trimester Maternal Cytomegalovirus Infection and Stillbirth: A Prospective Cohort Study

Song

Diao

et al. 2022

Front. Pediatr.

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BackgroundGiven that the time lag between cytomegalovirus (CMV) screening and diagnosed testing, a better knowledge of the association between pregnant women with CMV screening test positive and stillbirth in an epidemiological perspective was required to assist people being counseled reframe their pregnancy and birth plans based on the magnitude of the risk.MethodsThis study recruited 44048 eligible pregnant women from March 13, 2013 to December 31, 2019. Serological tests including CMV-specific IgM and IgG, and IgG avidity index were used to screen for maternal CMV infection and were measured by automated chemiluminescence immunoassay. The association was assessed using the inverse probability of group-weighted multivariate-adjusted log-binomial models.ResultsA total of 540 infants ended with a stillbirth (12.3 per 1000 pregnancies), and 2472 pregnancies with maternal CMV infection were screened out (56.1 per 1000 pregnancies) among all eligible pregnancies. In the comparison analysis, 326 infants ended with a stillbirth (86.6 per 1000 pregnancies) in the maternal CMV infection group compared with 214 infants (7.8 per 1000 pregnancies) in the group where mothers were not infected with CMV (RR 12.17; 95% CI 9.43–15.71). After excluding the pregnancies of stillbirth with birth defects, a strong association between the two groups was still observed (RR 9.38; 95% CI 6.92–12.70).ConclusionOur findings quantified the risk of a woman having a baby with stillbirth if she had a positive serologic CMV screening test in her first trimester, and supported the value of using CMV serologic tests as part of regular testing in pregnant women.Trial registrationRegistered in Chinese Clinical Trial Registry Center; registration number, ChiCTR1800016635; registration date, 06/14/2018 (Retrospectively registered); URL of trial registry record, https://www.chictr.org.cn/showproj.aspx?proj=28300.

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“…Maternal infection can be sensitively and reliably diagnosed with CMV serology and avidity testing. 10,11 A positive IgM and IgG with a low IgG avidity indicates infection in the preceding 3 months with a sensitivity and specificity of over 90%, 12 while amniocentesis for fetal infection has a 100% specificity and 85-95% sensitivity to detect fetal infection.…”

mentioning

confidence: 99%

Congenital cytomegalovirus infection: Advocating for screening and education

Chan

Yang

Thong

2022

Ann Acad Med Singap

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Advocating for cytomegalovirus maternal serologic screening in the first trimester of pregnancy: if you do not know where you are going, you will wind up somewhere else

Cited by 17 publications

References 43 publications

Role of fetal magnetic resonance imaging in fetuses with congenital cytomegalovirus infection: multicenter study

Role of fetal magnetic resonance imaging in fetuses with congenital cytomegalovirus infection: multicenter study

Association Between First-Trimester Maternal Cytomegalovirus Infection and Stillbirth: A Prospective Cohort Study

Congenital cytomegalovirus infection: Advocating for screening and education

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